Individual provider Active NPI

Corina Suzanne Gonzalez, OTR

  • Occupational Therapist
  • Mission, TX
National Provider Identifier
1538336227
Registry record updated May 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
112253 Issued in TX
Practice address
2521 E Interstate Highway 2 Ste 600
Mission, TX 78572-9811
Phone
(956) 997-6100
Fax
(956) 229-6185
NPI assigned
May 12, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 10, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 112253 TX Primary

Addresses

Primary practice location

2521 E Interstate Highway 2 Ste 600
Mission, TX 78572-9811

Mailing address

367 S Gulph Rd
King of Prussia, PA 19406-3121
Phone (956) 997-6100

Other practice location 1

228 E Mile 3 Rd Ste 190B
Mission, TX 78573-0156
Phone (956) 997-6565

Other practice location 2

6400 N 10th St
Suite C
McAllen, TX 78504-3385
Phone (956) 451-8853

Other identifiers 2

IdentifierTypeStateIssuer
193320203MedicaidTX
1O2237OtherTXPTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
112253TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Core Therapeutics, LLC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1210550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620604800000",
    "number": "1538336227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "367 S GULPH RD",
            "city": "KING OF PRUSSIA",
            "state": "PA",
            "postal_code": "194063121",
            "telephone_number": "956-997-6100",
            "fax_number": "956-229-6185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2521 E INTERSTATE HIGHWAY 2 STE 600",
            "city": "MISSION",
            "state": "TX",
            "postal_code": "785729811",
            "telephone_number": "956-997-6100",
            "fax_number": "956-229-6185"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "228 E Mile 3 Rd Ste 190B",
            "address_purpose": "LOCATION",
            "city": "Mission",
            "state": "TX",
            "postal_code": "785730156",
            "country_code": "US",
            "telephone_number": "956-997-6565",
            "fax_number": "956-229-6188",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6400 N 10th St",
            "address_2": "Suite C",
            "address_purpose": "LOCATION",
            "city": "McAllen",
            "state": "TX",
            "postal_code": "785043385",
            "country_code": "US",
            "telephone_number": "956-451-8853",
            "fax_number": "956-687-9102",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "CORINA",
        "middle_name": "SUZANNE",
        "name_prefix": "Mrs.",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-12",
        "last_updated": "2021-05-10",
        "certification_date": "2021-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "112253",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "193320203",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "1O2237",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mission, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.